You probably associate bloodletting probably with quack doctors from the bygone times, when you as a sick person tried to stay as far away as possible from doctors and hospitals. You probably do not think of pharmacological bodybuilders who have used too many anabolic steroids. Except if you happen to have read the article that the Irish researcher Rebekah Brennan published in the International Journal on Drug Policy. Not? Let us bring you up to speed.

Bloodletting
Brennan stumbled upon the practice of bloodletting in bodybuilding when she was studying web forums for steroids users. On these forums she found messages in which users of heavy doses of anabolics drained blood when they suffered from side effects of their gear, such as high blood pressure and a red face.

This red face can be due to high blood pressure, but also to an increased concentration of red blood cells in the bloodstream. Anabolic steroids stimulate the production of those cells. Because red blood cells transport oxygen, the endurance can increase, but the blood also becomes more viscous. This can increase blood pressure, but also the risk of infarction.

By tapping 250 to 500 milliliters of blood, the users try to protect themselves against these side effects, Brennan discovered. In the forums, users with experiential knowledge give interested parties tips on, for example, the right types of hypodermic needles, hygiene, the benefit of increased fluid intake on the day before the bloodletting and the possibility of having someone around during the bloodletting can can intervene in case of fainting.

"Bloodletting may be conceptualised as part of a repertoire of behaviours which signifies a distinction between a casual and a committed performance and image enhancing drugs lifestyle, and a hallmark of membership to an elite group of serious anabolic steroids injectors who can handle high levels of risk", Brennan writes.

Conclusion
"Our study is intended to provide the first snapshot of online communal activity around practice of self-phlebotomy or bloodletting amongst people who inject anabolic steroids", writes Brennan. "Further research in this area is warranted, and will be of benefit to healthcare workers, treatment providers and policy makers particularly as this relates to evidence informed and targeted harm reduction policies and effective public health interventions."

Underground injectable containing arsenic kills bodybuilder
Chemical athletes who buy substances in ampoules and vials on the black market run the risk of their stuff being under-dosed or not containing any active ingredients at all. They also run the risk of obtaining materials that are completely different from what they were after.